Correlation between Fistula Risk Score with Post Operative Pancreatic Fistula - A Single Centre Indian Study

Abstract

Introduction: Post operative pancreatic fistula (POPF) is a major cause of morbidity and mortality of pancreatic surgeries done for management of malignancy or chronic pancreatitis. This study was undertaken in our centre as an introspective into the rate of POPF and its predictability assessment. Aims and Objectives: To look for the incidence of POPF in Medical College, Kolkata, India and its correlation with the existing Fistula Risk Score (FRS). Methods: This was a retrospective single centre study. All the existing records of patients undergoing Pylorus preserving pancreaticoduodenectomy(PPPD) and pancreatic drainage or resection procedures were evaluated. POPF and FRS were defined as per the latest International Study Group on Pancreatic Fistula (ISGPF) 2016 guideline. Results: From 2016 to 2021, 31 patients underwent PPPD and 45 patients underwent pancreatic drainage or resection procedures. Of these, seven patients developed POPF. Three patients had only biochemical leak and 2 had Grade B and 1 had Grade C leak. All were from PPPD group. The mean FRS was 2. Three patients had soft pancreatic parenchyma. The mean Main Pancreatic Duct(MPD) diameter was 3.5mm. Conclusion: This study reflects an encouraging data carrying cumulative incidence of POPF of 9.21% comparable with the world data (3%-45%). It carries a mortality risk of nearly 1%. In our centre one patient succumbed. No statistically significant correlation found (correlation coefficient 0.022) between rate of POPF and FRS. Post operative hospital stay was found to be significantly prolonged with POPF,17.62 days with POPF vs 13.36 days without POPF(p- value: 0.045 ).